Dengue epidemic early warning system for Brazil

Copyright © 2015 UNISDR (United Nations International Strategy for Disaster Reduction)The problem Brazil has reported more cases of dengue fever than anywhere else in the world this century1. Many cities have tropical and sub-tropical climate conditions that allow the dengue mosquito to thrive during warmer, wetter and more humid months, particularly in densely populated urban areas. Dengue epidemics depend on mosquito abundance, virus circulation and human susceptibility. In order to prepare for dengue epidemics, early warning systems, which take into account multiple dengue risk factors, are required to implement timely control measures. Seasonal climate forecasts provide an opportunity to anticipate dengue epidemics several months in advance ...European Commission’s Seventh Framework Research Programme project DENFREEEuropean Commission’s Seventh Framework Research Programme project EUPORIASEuropean Commission’s Seventh Framework Research Programme project SPECSConselho Nacional de Desenvolvimento Científico e TecnológicoFundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ

Dengue outlook for the World Cup in Brazil: an early warning model framework driven by real-time seasonal climate forecasts.

PublishedJournal ArticleResearch Support, Non-U.S. Gov'tBACKGROUND: With more than a million spectators expected to travel among 12 different cities in Brazil during the football World Cup, June 12-July 13, 2014, the risk of the mosquito-transmitted disease dengue fever is a concern. We addressed the potential for a dengue epidemic during the tournament, using a probabilistic forecast of dengue risk for the 553 microregions of Brazil, with risk level warnings for the 12 cities where matches will be played. METHODS: We obtained real-time seasonal climate forecasts from several international sources (European Centre for Medium-Range Weather Forecasts [ECMWF], Met Office, Meteo-France and Centro de Previsão de Tempo e Estudos Climáticos [CPTEC]) and the observed dengue epidemiological situation in Brazil at the forecast issue date as provided by the Ministry of Health. Using this information we devised a spatiotemporal hierarchical Bayesian modelling framework that enabled dengue warnings to be made 3 months ahead. By assessing the past performance of the forecasting system using observed dengue incidence rates for June, 2000-2013, we identified optimum trigger alert thresholds for scenarios of medium-risk and high-risk of dengue. FINDINGS: Our forecasts for June, 2014, showed that dengue risk was likely to be low in the host cities Brasília, Cuiabá, Curitiba, Porto Alegre, and São Paulo. The risk was medium in Rio de Janeiro, Belo Horizonte, Salvador, and Manaus. High-risk alerts were triggered for the northeastern cities of Recife (p(high)=19%), Fortaleza (p(high)=46%), and Natal (p(high)=48%). For these high-risk areas, particularly Natal, the forecasting system did well for previous years (in June, 2000-13). INTERPRETATION: This timely dengue early warning permits the Ministry of Health and local authorities to implement appropriate, city-specific mitigation and control actions ahead of the World Cup. FUNDING: European Commission's Seventh Framework Research Programme projects DENFREE, EUPORIAS, and SPECS; Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro.DENFREE projectEUPORIAS projectSPECS projectEuropean Commission's Seventh Framework Research ProgrammeConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado do Rio de Janeir

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

The Monarch Initiative in 2019: an integrative data and analytic platform connecting phenotypes to genotypes across species.

In biology and biomedicine, relating phenotypic outcomes with genetic variation and environmental factors remains a challenge: patient phenotypes may not match known diseases, candidate variants may be in genes that haven\u27t been characterized, research organisms may not recapitulate human or veterinary diseases, environmental factors affecting disease outcomes are unknown or undocumented, and many resources must be queried to find potentially significant phenotypic associations. The Monarch Initiative (https://monarchinitiative.org) integrates information on genes, variants, genotypes, phenotypes and diseases in a variety of species, and allows powerful ontology-based search. We develop many widely adopted ontologies that together enable sophisticated computational analysis, mechanistic discovery and diagnostics of Mendelian diseases. Our algorithms and tools are widely used to identify animal models of human disease through phenotypic similarity, for differential diagnostics and to facilitate translational research. Launched in 2015, Monarch has grown with regards to data (new organisms, more sources, better modeling); new API and standards; ontologies (new Mondo unified disease ontology, improvements to ontologies such as HPO and uPheno); user interface (a redesigned website); and community development. Monarch data, algorithms and tools are being used and extended by resources such as GA4GH and NCATS Translator, among others, to aid mechanistic discovery and diagnostics

Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings: In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30–30·30 million) new cases of TBI and 0·93 million (0·78–1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331–412) per 100 000 population for TBI and 13 (11–16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40–57·62 million) and of SCI was 27·04 million (24·98–30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (−0·2% [–2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (−3·6% [–7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0–10·4 million) YLDs and SCI caused 9·5 million (6·7–12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82–141) per 100 000 for TBI and 130 (90–170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. Interpretation: TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. Funding: Bill & Melinda Gates Foundation

Increasing risk of Amazonian drought due to decreasing aerosol pollution

The Amazon rainforest plays a crucial role in the climate system, helping to drive atmospheric circulations in the tropics by absorbing energy and recycling about half of the rainfall that falls on it. This region (Amazonia) is also estimated to contain about one-tenth of the total carbon stored in land ecosystems, and to account for one-tenth of global, net primary productivity. The resilience of the forest to the combined pressures of deforestation and global warming is therefore of great concern, especially as some general circulation models (GCMs) predict a severe drying of Amazonia in the twenty-first century. Here we analyse these climate projections with reference to the 2005 drought in western Amazonia, which was associated with unusually warm North Atlantic sea surface temperatures (SSTs). We show that reduction of dry-season (July–October) rainfall in western Amazonia correlates well with an index of the north–south SST gradient across the equatorial Atlantic (the 'Atlantic N–S gradient'). Our climate model is unusual among current GCMs in that it is able to reproduce this relationship and also the observed twentieth-century multidecadal variability in the Atlantic N–S gradient, provided that the effects of aerosols are included in the model. Simulations for the twenty-first century using the same model3, 8 show a strong tendency for the SST conditions associated with the 2005 drought to become much more common, owing to continuing reductions in reflective aerosol pollution in the Northern Hemisphere

MEP and planetary climates: insights from a two-box climate model containing atmospheric dynamics

A two-box model for equator-to-pole planetary heat transport is extended to include simple atmospheric dynamics. The surface drag coefficient CD is treated as a free parameter and solutions are calculated analytically in terms of the dimensionless planetary parameters η (atmospheric thickness), ω (rotation rate) and ξ (advective capability). Solutions corresponding to maximum entropy production (MEP) are compared with solutions previously obtained from dynamically unconstrained two-box models. As long as the advective capability ξ is sufficiently large, dynamically constrained MEP solutions are identical to dynamically unconstrained MEP solutions. Consequently, the addition of a dynamical constraint does not alter the previously obtained MEP results for Earth, Mars and Titan, and an analogous result is presented here for Venus. The rate of entropy production in an MEP state is shown to be independent of rotation rate if the advective capability ξ is sufficiently large (as for the four examples in the solar system), or if the rotation rate ω is sufficiently small. The model indicates, however, that the dynamical constraint does influence the MEP state when ξ is small, which might be the case for some extrasolar planets. Finally, results from the model developed here are compared with previous numerical simulations in which the effect of varying surface drag coefficient on entropy production was calculated

On the visualization, verification and recalibration of ternary probabilistic forecasts.

We develop a graphical interpretation of ternary probabilistic forecasts in which forecasts and observations are regarded as points inside a triangle. Within the triangle, we define a continuous colour palette in which hue and colour saturation are defined with reference to the observed climatology. In contrast to current methods, forecast maps created with this colour scheme convey all of the information present in each ternary forecast. The geometrical interpretation is then extended to verification under quadratic scoring rules (of which the Brier score and the ranked probability score are well-known examples). Each scoring rule defines an associated triangle in which the square roots of the score, the reliability, the uncertainty and the resolution all have natural interpretations as root mean square distances. This leads to our proposal for a ternary reliability diagram in which data relating to verification and calibration can be summarized. We illustrate these ideas with data relating to seasonal forecasting of precipitation in South America, including an example of nonlinear forecast calibration. Codes implementing these ideas have been produced using the statistical software package R and are available from the authors